What is Narcissistic Personality Disorder?

“Narcissist” became a popular word in recent years. But what does it really mean?

Symptoms of Narcissistic Personality Disorder

Individuals with Narcissistic Personality Disorder (NPD) have a grandiose self-image, an unquenchable need for admiration, and lack empathy. In addition to these basic characteristics, they will also identify with at least five of the following:

• Believes they are superior to others and expects to be treated as such
• Believes they are special and unique and that normal people aren’t capable of understanding them
• Spends a great deal of time thinking about obtaining unlimited success, power, brilliance, or beauty
• Expects an excessive and ongoing amount of admiration and praise
• Feels entitled to special treatment and expects others to comply with their unreasonable expectations
• Takes advantage of other people
• Does not care about the feelings or needs of others
• Views life as a competition and becomes envious and upset when someone else is honored; also believes that others are constantly envious of them
• Arrogant attitude and behavior

Occasional selfishness or arrogance does not necessarily mean someone has Narcissistic Personality Disorder. In order to be officially diagnosed, there must be an ongoing pattern of these attitudes and behaviors. They must begin by early adulthood and be noticeable in various settings such as work, dating relationships, school, or with family.

Narcissistic Tendencies

Individuals with this disorder believe that they are more important than others, although they may or may not verbally acknowledge this. They may come across with false humility — attempting to appear humble while actually taking great pleasure in receiving praise or special treatment. Or they may come across as boastful and entitled. Regardless of how they outwardly express it, they inwardly believe that they are superior and deserve to be treated as such.

It is common for individuals with this disorder to overestimate their own abilities and to underestimate the abilities of everyone else. They tend to brag and tell inflated stories about their successes and are shocked and offended if others don’t lavish them with the admiration they feel they deserve. If someone else experiences success or victory, they will become jealous and angry.

Individuals with Narcissistic Personality Disorder often demand the “top” person — the most highly acclaimed doctor, the most prestigious attorney, or they may insist on speaking with the CEO regarding a trivial complaint. They prefer to affiliate with prestigious institutions and align themselves with renowned or impressive experts. They believe that only the best of the best is good enough for them.

Their arrogance is evident in the way that they demean and belittle others. They may loudly complain about a clumsy waiter’s “stupidity” or talk down to a receptionist who asks them to please hold. They can be condescending, patronizing, and judgmental. Even within their own families, they tend to view their relatives as beneath them, but never hesitate to let them know when there is something they need from them. They expect consistent love and support but unfortunately do not usually return it (unless it is for “show.”)

Another facet of Narcissistic Personality Disorder is the tendency to be grandiose — in other words, to “go big.” Whatever they set out to do, they overdo it. For example, they plan parties and events that are way too large and tend to view everything as a competition.

Relationship Challenges

Relationships are a huge challenge for individuals with this disorder because others usually become exhausted with their constant need for attention and admiration. They expect their arrival to be greeted with great fanfare, they frequently fish for compliments, and they expect conversations and plans to always revolve around them. Others complain that they get tired of having to “stroke their ego.”

Individuals with Narcissistic Personality Disorder typically put their own needs first. They do not stop to consider what someone else might feel or how they might be affected, nor do they care. They tend to use and exploit people in whatever way they find beneficial. They do not have reasonable expectations for other people, but instead feel entitled to their dedication and loyalty. They often complain about the ungratefulness of others.

They expect to be catered to and, if this doesn’t happen, they may be first puzzled and then furious. They may believe that rules shouldn’t apply to them or that they shouldn’t have to wait in line. They may believe they are above reproach and, if challenged, may respond with a comment like, “how DARE you question me?!” If pulled over by a police officer, they might ask, “Do you not know who I am?!”

Other than anger, individuals with NPD do not generally exhibit very many emotions.

Occupational Challenges

As employees, individuals with Narcissistic Personality Disorder struggle to be able to accept coaching, feedback, or criticism from their employers. They find this to be humiliating and degrading, even if it was kindly worded, and often respond with anger or defiance. They often abruptly resign because they’re so uncomfortable not being the person in charge.

They much prefer to be their own boss. But if they supervise others, they may overwork their staff with no thought or concern about how their lives may be impacted. They have unrealistic expectations, both for production and for receiving the amount of praise they desire. As a result, they often have high staff turnover.

Individuals with this disorder are not always as successful vocationally as we might expect. This is because they are often unwilling to take risks or make necessary changes if they fear that defeat might be a possible outcome.

Mental and Medical Health Challenges

Narcissistic Personality Disorder is significantly more prevalent in males than females. Many individuals with this disorder also struggle with depression, anorexia nervosa, and substance use disorders. Also, it is not uncommon for these individuals to simultaneously be diagnosed with histrionic, borderline, antisocial, or paranoid personality disorders.

Psychotherapy is the recommended treatment for individuals with NPD as well as for those who need help healing from relationships with them. Reach out to a trusted mental health professional to begin your healing journey today.

Diagnostic criteria for Narcissistic Personality Disorder is taken from the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, published by the American Psychiatric Association. For more information on personality disorders, please visit What is a Personality Disorder? – Navigating Life (juliebailey.net) and Get Help With Personality Disorders (psychiatry.org)